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HomeMy WebLinkAboutBLDE-22-003233 Commonwealth of Official Use Only Massachusetts E.�,,� Permit No. BLDE-22-003233 ; BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:12/7/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described bel Location(Street&Number) 77 BAXTER AVE (—fp 43. 78 Owner or Tenant STEERE JOHN CALVERT elephone No. Owner's Address C/O ROBERT C STEERE, P 0 BOX 7551, CUMBERLAND, RI 02864 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Rough&finish first floor&basement. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 33 No.of Ceil:Susp.(Paddle)Fans 2 No.of Total Transformers KVA No.of Luminaire Outlets 14 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 43 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 36 No.of Gas Burners 1 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. 1 Total 3 No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers 1 Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) itt1 — /'q i- 11('/_ 38 I certify,under the pains and penalties of perjury,that the information on this application is true and complete. (p (E7 FIRM NAME: Raymond L Gagnon Licensee: Raymond L Gagnon Signature LIC.NO.: 34850 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 7203, CUMBERLAND RI 028640813 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But my signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PE IT FEE: $75.00 ctit 180tu_CVLS at-- P 1� I-( fr4 Rom©4 1{_3 f2i- _ RECEIVED DEC 0 7 2Q „u,►o,�. olcc?77�/a Services Permit No. 2-3Official Use 2'33 t� ' �._.sTart wnf o/ ire Services U I L i DEPARTMENT Occupancy and Fee Checked ,,, ,y FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 • (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: .64tZ. Vol / ...:.... City or Town of: tc/L j-/- y�i'fl 01i ff To the InspectorWires: • By this application the undersigned gives nodce of his or her intention to perform the electrical work described below. Location(Street&Number) 7 7 54)C7? Ave Telephone No r Owner or Tenant /?� �", E 42ie j S/�4j� g.... Owner's Address 71 j' `j< �i-,� We L o,,i- Is this permit in conjunction with a building permit? Yes J No 0 (Check Appropriate Box) Purpose of Building ,S/iVi / Film ty Utility Authorization No. • Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters bNew Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 1 f j6/f dt . /wl.S/t G14R1/2/ eXSrg-/-7sv( A/ (6-- C{ t 6 icLu02 d'- 1634-5"e746)1. ni Completion of the follasvistktabk my be waived by the lxctor of Wires. No.of Recessed Luminaires No.of CellNo.of Total 3 3 '(Paddle)Fans Transformers KVA .\ No.of Luminaire Outlets j No.of Hot Tubs O Generators KVA Above In- No.of Emergency Lighting 4-- No.of Luminaires a / Swimming Pool ice. ❑ grad. ❑ Battery Units �t No.of Receptacle Outlets 7 3 No.of 011 Burners FIRE ALARMS No.of Zones No.of Switches 36 No.of Gas Burners / 'No.If �tabna Devces No.of Ranges n No.of Air Cond. / Ton l 3 No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons .. KW. 'No.of Self-Contained Totals: �_ __�_ ___KW___ Detection/Ale Devlces No.of Dishwashers / Space/Area Heating KW Local 0 Monnn�ection 0 OtherC No.of Dryers Heating Appliances KW Security'Systems:* No.of Devices or Equivalent No.of Water // KW� No.of No.of Data Wiring: Heaters b5 Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs 0 No.of Motors Total HP Tekco o fses or Ru nt OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: /O,�v (When required by municipal policy.) Work to Start: j9 I0/ ./ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the Information on this application is true and complete FIRM NAME: /Q4 6 4Gtieti /7 ?, //t/G• LIC.NO.: Licensee: 3/ '—) �-- /QY{c/f'YIdND 6/�'f ature �'�j�/ LIC.NO.:3*ec o E. (If applicable, tempt"in the license line.) Bus.Tel.No.:M GT) 663 Address: f,0, ifo/C 701 d 3 G'M p4-Dl g ark- Aft.TeL No.: •Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability inuance coverage normally required by law. : my si :.ture below,I hereby waive this requirement. I am the(check one) owner 0 owner's agent. Owner/Agent ,/ A/ Signature /stir Telephone No. I PERMIT FEE:$